CMS Formulary

Displaying 81221-81230 of 1611142 results.
ID: 81221
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 597977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81222
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 597971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81223
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81224
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81225
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81226
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81227
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 198430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81228
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 252478
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81229
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 103968
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 81230
Formulary ID: 00021029
Formulary Version: 14
Contract Year: 2021
RXCUI: 252479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0